Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.00 / $2,988.00 / $14,699.00	Facility		$275.00	$2,988.00	$14,699.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $43.10 / $56.22 / $297.48	Facility	52	$43.10	$56.22	$297.48
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $17.23 / $22.49 / $118.99	Facility	53	$17.23	$22.49	$118.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.76 / $161.94 / $501.00	Professional		$87.76	$161.94	$501.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $39.89 / $67.52 / $289.69	Professional	52	$39.89	$67.52	$289.69
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $17.23 / $41.36 / $118.99	Professional	53	$17.23	$41.36	$118.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.63 / $115.47 / $193.42	Professional		$85.63	$115.47	$193.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,505.00 / $9,119.00	Facility		$1,723.00	$4,505.00	$9,119.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.00 / $151.38 / $290.57	Professional		$98.00	$151.38	$290.57
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $1,588.01	Facility		$66.00	$100.00	$1,588.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $122.22 / $274.20	Professional		$90.76	$122.22	$274.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.38 / $77.26 / $182.02	Facility		$65.38	$77.26	$182.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.05 / $120.14 / $290.50	Professional		$82.05	$120.14	$290.50
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $41.04 / $74.23 / $130.79	Professional		$41.04	$74.23	$130.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.43 / $104.61 / $180.65	Professional		$62.43	$104.61	$180.65
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $293.32 / $303.00	Facility		$55.00	$293.32	$303.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $126.65 / $242.40 / $242.40	Facility	52	$126.65	$242.40	$242.40
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $31.66 / $60.60 / $60.60	Facility	53	$31.66	$60.60	$60.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $452.72 / $719.92 / $845.55	Professional		$452.72	$719.92	$845.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.92 / $119.10 / $163.25	Facility		$74.92	$119.10	$163.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.14 / $125.21 / $272.39	Professional		$85.14	$125.21	$272.39
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $206.97 / $206.97 / $319.97	Professional		$206.97	$206.97	$319.97
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $41.04 / $61.56 / $132.04	Professional		$41.04	$61.56	$132.04
United Facility/Professional Facility Modifier Low / Median / High Price $421.00 / $1,495.00 / $6,323.00	Facility		$421.00	$1,495.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $119.31 / $322.08	Professional		$81.20	$119.31	$322.08